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https://www.readbyqxmd.com/read/29910726/-n-palmitoylethanolamine-supplementation-for-long-lasting-low-dosed-morphine-antinociception
#1
Lorenzo Di Cesare Mannelli, Laura Micheli, Elena Lucarini, Carla Ghelardini
The facilitation of opioid medication is eliciting a nemetic problem since increasing overdose deaths involve prescription of opioid pain relievers. Chronic painful diseases require higher doses of opioids, progressively with the development of tolerance to the antinociceptive effect. Novel strategies for the maintenance of low dosed opioid effectiveness are necessary to relieve pain and decrease abuse, overdose, and side effects. N -Palmitoylethanolamine (PEA) is an endogenous compound able to preserve the homeostasis of the nervous system and to delay the development of morphine tolerance...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29899455/structure-of-the-%C3%A2%C2%B5-opioid-receptor-g-i-protein-complex
#2
Antoine Koehl, Hongli Hu, Shoji Maeda, Yan Zhang, Qianhui Qu, Joseph M Paggi, Naomi R Latorraca, Daniel Hilger, Roger Dawson, Hugues Matile, Gebhard F X Schertler, Sebastien Granier, William I Weis, Ron O Dror, Aashish Manglik, Georgios Skiniotis, Brian K Kobilka
The μ-opioid receptor (μOR) is a G-protein-coupled receptor (GPCR) and the target of most clinically and recreationally used opioids. The induced positive effects of analgesia and euphoria are mediated by μOR signalling through the adenylyl cyclase-inhibiting heterotrimeric G protein Gi . Here we present the 3.5 Å resolution cryo-electron microscopy structure of the μOR bound to the agonist peptide DAMGO and nucleotide-free Gi . DAMGO occupies the morphinan ligand pocket, with its N terminus interacting with conserved receptor residues and its C terminus engaging regions important for opioid-ligand selectivity...
June 13, 2018: Nature
https://www.readbyqxmd.com/read/29891211/effective-thiafentanil-immobilization-and-physiological-responses-of-free-ranging-moose-alces-alces-in-northern-sweden
#3
Daniela Sb Barros, Alina L Evans, Jon M Arnemo, Fredrik Stenbacka, Göran Ericsson
OBJECTIVE: To evaluate clinical and physiological responses in moose to thiafentanil administration for immobilization. STUDY DESIGN: Cross-sectional clinical study. ANIMALS: Eleven (six males and five females) free-ranging adult moose (Alces alces). METHODS: Each moose was darted from a helicopter with 7.5 mg thiafentanil during March 2014 in northern Sweden. Physiological evaluation included vital signs and blood gases...
March 31, 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29889698/perineural-low-dose-dexamethasone-prolongs-interscalene-block-analgesia-with-bupivacaine-compared-with-systemic-dexamethasone-a-randomized-trial
#4
Richard L Kahn, Jennifer Cheng, Yuliya Gadulov, Kara G Fields, Jacques T YaDeau, Lawrence V Gulotta
BACKGROUND AND OBJECTIVES: Perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration. The effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater. This triple-blind, randomized trial examined the effect of 1 mg IV versus perineural dexamethasone on interscalene block (ISB) analgesia duration. METHODS: Patients undergoing ambulatory shoulder arthroscopy received an ultrasound-guided ISB with 15 mL bupivacaine 0...
June 8, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29887239/effect-of-multimodal-analgesia-with-paravertebral-blocks-on-biochemical-recurrence-in-men-undergoing-open-radical-prostatectomy
#5
Liam C Macleod, Robert M Turner, Samia Lopa, Lee A Hugar, Benjamin J Davies, Bruce Ben-David, Jacques E Chelly, Bruce L Jacobs, Joel B Nelson
BACKGROUND: Recent studies suggest that anesthetic technique during radical prostatectomy for prostate cancer may affect recurrence or progression. This association has previously been investigated in series that employ epidural analgesia. The objective of this study is to determine the association between the use of a multimodal analgesic approach incorporating paravertebral blocks and risk of biochemical recurrence following open radical prostatectomy. PATIENTS AND METHODS: Using a prospective database of 3,029 men undergoing open radical prostatectomy by a single surgeon, we identified 2,909 men who received no neoadjuvant androgen deprivation and had at least 1 year of follow up...
June 7, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29869799/mu-opioid-antagonists-for-opioid-induced-bowel-dysfunction-in-people-with-cancer-and-people-receiving-palliative-care
#6
REVIEW
Bridget Candy, Louise Jones, Victoria Vickerstaff, Philip J Larkin, Patrick Stone
BACKGROUND: Opioid-induced bowel dysfunction (OIBD) is characterised by constipation, incomplete evacuation, bloating, and gastric reflux. It is one of the major adverse events of treatment for pain in cancer and in palliative care, resulting in increased morbidity and reduced quality of life.This is an update of two Cochrane reviews. One was published in 2011, Issue 1 on laxatives and methylnaltrexone for the management of constipation in people receiving palliative care; this was updated in 2015 and excluded methylnaltrexone...
June 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29799282/analysis-of-predictors-of-opioid-free-analgesia-for-management-of-acute-post-surgical-pain-in-the-united-states
#7
Richard D Urman, Elaine A Böing, Victor Khangulov, Randi Fain, Brian H Nathanson, George J Wan, Belinda Lovelace, An T Pham, Jessica Cirillo
OBJECTIVES: Utilization of opioid-free analgesia (OFA) for post-surgical pain is a growing trend to counter the risks of opioid abuse and opioid-related adverse drug events (ORADEs). However, utilization patterns of OFA have not been examined. In this study, we investigated the utilization patterns and predictors of OFA in a surgical population in the United States. METHODS: Analysis of the Cerner Health Facts® database (1/2011 to 12/2015) was conducted to describe hospital and patient characteristics associated with OFA...
May 25, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29784431/-continuous-quadratus-lumborum-type-ii-block-in-partial-nephrectomy
#8
Rita Graça, Pilar Miguelez, José Miguel Cardoso, Miguel Sá, Joana Brandão, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Quadratus lumborum block was first described in 2007 and currently there are descriptions of its achievement through four different injection points. This blockage provides abdominal wall and visceral analgesia, and one of its mechanisms is the dispersion of the local anesthetic into the paravertebral space. We describe the performance of a continuous quadratus lumborum type II block for postoperative analgesia in a partial nephrectomy. CASE REPORT: A 64-year-old woman, scheduled for partial left laparoscopic nephrectomy...
May 18, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29779547/policy-pathways-to-address-provider-workforce-barriers-to-buprenorphine-treatment
#9
Rebecca L Haffajee, Amy S B Bohnert, Pooja A Lagisetty
At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part of medication-assisted treatment has high potential to address this gap because of its approval for use in non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, less than 4% of licensed physicians are approved to prescribe buprenorphine for opioid use disorder, and approximately 47% of counties lack a buprenorphine-waivered physician...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#10
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29775728/opioid-free-anaesthesia-why-and-how-a-contextual-analysis
#11
REVIEW
Patrice Forget
If the use of natural opiates, such as opium, is more than millennial, the history of synthetic opioids begins after 1950, with the development of the so-called 'modern' anaesthetic techniques. In 1962, in Belgium, the use of fentanyl, the first synthetic opioid for use in anaesthesia, is described. Subsequently, the use of opioids at high doses during surgery became common. However, over the last twenty years, many studies have questioned this practice, highlighting the many unknowns as the side effects of these molecules...
May 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29757780/effects-of-intraoperative-opioid-use-on-recurrence-free-and-overall-survival-in-patients-with-esophageal-adenocarcinoma-and-squamous-cell-carcinoma
#13
Kim N Du, Lei Feng, Abigail Newhouse, Jeel Mehta, Javier Lasala, Gabriel E Mena, Wayne L Hofstetter, Juan P Cata
BACKGROUND: Perioperative opioid use is associated with poor survival in patients with esophageal squamous cell carcinoma. The most common histological type of esophageal cancer in western countries is adenocarcinoma. The objective of this study was to evaluate the association between intraoperative opioid consumption and survival in patients with adenocarcinoma and squamous cell carcinoma of the esophagus. METHODS: Records of patients who had undergone esophageal cancer surgery between January 2000 and January 2017 were reviewed...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29756302/velopharyngeal-dysfunction-from-intranasal-substance-abuse-case-series-and-review-of-literature
#14
Peng You, Linda Chow, Anne Dworschak-Stokan, Murad Husein
OBJECTIVE: Intranasal substance abuse with cocaine or opioids can result in complications involving the midline nasal and oral structures. When the defect involves the velopharyngeal musculature, this leads to velopharyngeal dysfunction (VPD). This article aims to illustrate this clinical entity through a series of four patients and a review of the literature. METHODS: A series of four cases of VPD due to intranasal narcotic use and their management are discussed...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#15
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739542/different-protocols-used-today-to-achieve-total-opioid-free-general-anesthesia-without-locoregional-blocks
#16
REVIEW
Eckhard Mauermann, Wilhelm Ruppen, Oliver Bandschapp
With increasing awareness of both short- and long-term problems associated with liberal perioperative opioid administration, the need for routinely and clinically feasible alternatives is greater than ever. Opioid-free anesthesia-previously reserved for bariatric surgery-is receiving increasing attention in mainstream anesthesia. In this review, we present the truly multimodal concept of opioid-free anesthesia, which circumvents a number of opioid-related problems. For a concrete clinical perspective, we present in depth our opioid-free protocol for bariatric surgery...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739541/stable-anesthesia-with-alternative-to-opioids-are-ketamine-and-magnesium-helpful-in-stabilizing-hemodynamics-during-surgery-a-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#17
REVIEW
Patrice Forget, Juan Cata
INTRODUCTION: The role of ketamine and magnesium in improving postoperative pain and diminish opioid consumption has been largely described. Synthetic opioids are known to provide hemodynamic stability when given for major noncardiac surgery. Definitive evidence on the role of ketamine and/or magnesium on intraoperative hemodynamic control would support their potential as alternatives to opioids during surgery. METHODS: The available literature published on PubMed/Medline and EMBASE was reviewed systematically to perform meta-analyses of randomized controlled trials (RCTs) assessing the effect of ketamine and/or magnesium on hemodynamic response to surgery as the primary outcome...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739540/intravenous-lidocaine
#18
REVIEW
Jean-Pierre Estebe
Lidocaine has analgesic effect and antihyperalgesic and anti-inflammatory properties, which enable its use as a general anesthetic adjuvant. Lidocaine can reduce nociception and/or cardiovascular responses to surgical stress, postoperative pain, and/or analgesic requirements. However, its mechanisms of action remain unclear, despite its different known properties. Although the exact mechanism of action remains uncertain, initial bolus followed by a continuous lidocaine infusion has clear analgesic benefits...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739537/opioid-free-anesthesia-opioid-side-effects-tolerance-and-hyperalgesia
#19
REVIEW
Patricia Lavand'homme, Arnaud Steyaert
Opioids are the most potent drugs used to control severe pain. However, neuroadaptation prevents opioids' ability to provide long-term analgesia and produces opposite effects, i.e., enhancement of existent pain and facilitation of chronic pain development. Neuroadaptation to opioids use results in the development of two interrelated phenomena: tolerance and "opioid-induced hyperalgesia" (OIH). Tolerance, a pharmacologic concept, and OIH, a clinical syndrome, have been mostly observed under experimental conditions in animals and in human volunteers...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739534/opioid-free-general-anesthesia-a-new-paradigm
#20
EDITORIAL
J Mulier, M Dekock
No abstract text is available yet for this article.
December 2017: Best Practice & Research. Clinical Anaesthesiology
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